Cervical osteochondrosis is a disease in which the vertebrae and intervertebral discs are affected. Cervical osteochondrosis refers to deforming dorsopathies. Involutionary changes in discs have been observed already at the age of 20. At the same time, they become more sensitive to loads, less elastic, and lose lubricating fluid.
Most often, the pathology occurs in the elderly, but at present there is a significant increase in the incidence among children and adolescents. Neurologists identify cervical osteochondrosis using the latest diagnostic studies. After clarifying the diagnosis, complex therapy is carried out with the most effective drugs, physiotherapy procedures and innovative methods of physical rehabilitation.
The name of the disease consists of two Greek terms "osteon" (bone) and "chondros" (cartilage). Cervical osteochondrosis begins with changes in the central part of the disc. The intervertebral disc loses moisture, decreases in size, this leads to the convergence of the vertebral bodies and infringement of the nerve roots with the vessels. The vertebrae receive nutrients from the surrounding tissues, which is harmful to the body. Compression of nerves and blood vessels leads to a protective muscle spasm, which, as the disease progresses, becomes the cause of pain.
Which doctor treats this disease
Treatment of osteochondrosis is the field of activity of neurologists. However, if symptoms of osteochondrosis of the neck appear, it is possible to consult a general practitioner. A neurologist will select medications for cervical osteochondrosis that have the least stress on the body, which is important for drug therapy.
To determine the presence of a pathological process in the cartilage tissue and cervicobrachial osteochondrosis, the patient is referred for a comprehensive examination. The tactics of how to treat cervical osteochondrosis are being developed in accordance with research results.
Interdisciplinary collaboration also allows the treatment of comorbidities that the patient has. In addition, the patient receives full information support: a treatment plan, an extract on the cost of services, provision of information on specialist consultations and diagnostic measures.
Causes
Cervical osteochondrosis develops under the influence of a variety of provoking factors. No definite cause of cervical osteochondrosis has been identified. The disease is often associated with metabolic disorders and aging of the vertebrae.
Researchers suggest that cervical osteochondrosis develops for the following reasons:
- Excessive stress on the spine. A high load on the spine is observed when wearing the wrong shoes, flat feet, obesity, prolonged sitting position;
- Metabolic disorders. Deficiency of vitamins, minerals, calcium metabolism disorders can serve as the causes of degenerative processes in the vertebrae;
- Congenital and acquired anomalies of the spine and ligamentous apparatus (thickening of the ligaments, lumbarization, sacralization);
- Pathologies of the gastrointestinal tract, leading to insufficient absorption of nutrients;
- Infection, intoxication;
- Injuries, bruises, fractures of the spine, as a result of which the blood supply and innervation of the spinal column are disrupted, which causes their dystrophic disorders;
- Stress;
- Wearing shoes with heels;
- Pregnancy, especially multiple pregnancies;
- Autoimmune lesions of connective tissue, abnormal structure of collagen types 1 and 2;
- Occupational hazards (lifting heavy loads, prolonged vibration, working in a sitting position with a constant head tilt);
- Atherosclerotic and other changes in the vertebral arteries;
- Curvature of the spine (kyphosis, scoliosis, kyphoscoliosis).
An important risk factor for the development of cervical osteochondrosis is burdened heredity. This fact proves the presence of osteochondrosis in children, when the spine is not yet overloaded.
Degrees
Due to the special structure of the spine, it is able to perform its functions. The main structural unit is considered to be the spinal motion segment (VMS). It consists of two adjacent vertebrae, an intervertebral disc and a musculo-ligamentous apparatus. Osteochondrosis leads to dystrophic-degenerative processes, first in the intervertebral disc, then in the vertebra. With the defeat of one vertebra, the performance of its functions is provided by adjacent ones. This leads to an increase in the load and loss of mobility of the affected segment.
In the development of cervical osteochondrosis, doctors distinguish several stages:
- The first degree of cervical osteochondrosis. Since the intervertebral disc is deprived of its own blood supply and receives nutrients from the surrounding tissues, it is subject to degenerative changes. Osteochondrosis at the 1st stage of development is characterized by the destruction of the nucleus pulposus and cracks in the annulus fibrosus. Clinically, this is manifested by acute or persistent local pain in the neck (cervicalgia) and stiffness;
- Osteochondrosis of the second degree of the cervical spine. At this stage, destruction of the annulus fibrosus continues, pathological mobility and instability of the vertebrae appear. Patients complain of neck pain, aggravated by physical exertion, tilting the head or in a certain position;
- The third stage of the disease is characterized by complete destruction of the annulus fibrosus. The gelatinous nucleus is not fixed. Herniated discs can occur and cause severe pain. At this stage, due to poor fixation of the SMS, a curvature of the spine may form;
- At the fourth stage of the disease, the intervertebral disc is replaced by connective tissue, other adjacent segments are affected. Spondyloarthrosis, arachnoiditis develops. The joints become completely immobile - ankylosis develops. Bone tissue grows around the affected area - an osteon is formed. With the fourth degree of cervical osteochondrosis, vivid symptoms are observed: severe pain that radiates to the arm, sternum, to the area between the shoulder blades, sensitivity disorders.
Symptoms and Signs
Signs of cervical osteochondrosis at the initial stages can be nonspecific: dizziness, headaches, weakness, crunching during head movements. As the disease progresses, the following symptoms develop:
- Severe pain in the neck and shoulders;
- Numbness of the hand;
- Dizziness;
- Increased blood pressure;
- Impaired coordination of movements;
- Increased perspiration.
There are several syndromes that appear with the development of a pathological condition of the muscles of the back and cervical spine:
- Cervical migraine syndrome.
- Vertebral artery syndrome.
- Hypertensive syndrome.
- Cardiac syndrome.
- Radicular syndrome.
They occur when nerve endings are injured, arteries and veins are compressed during the development of the disease. The most dangerous complication is considered to be vertebral artery syndrome. There is a violation of blood flow through the artery that feeds the brain and spinal cord. The patient's hearing decreases, vision decreases, constant dizziness develops. The patient may lose consciousness while driving due to a sharp violation of blood flow.
As a result of compression of the nerves responsible for the innervation of the muscles of the chest and diaphragm, pain in the region of the heart appears, which is not associated with heart disease, but at the same time, tachycardia, arrhythmia and hypotension may develop. Compression of veins leads to the development of hypertensive CSF syndrome. Intracranial pressure increases, nausea, vomiting, and severe headache appear due to impaired blood outflow from the brain.
As a result of squeezing the neck, radicular syndrome develops - severe pain appears in the neck, shoulders, shoulder blades, and the back of the head. With this syndrome, the arms and neck area go numb. With cervical migraine syndrome, the patient is worried about severe pain in the occiput, which is often accompanied by nausea and vomiting.
Reflex syndromes occur when the spinal roots are not yet affected. Patients complain of pain in the neck, head (especially the back of the head), in the arms on one or both sides. Reflex pain, unlike radicular pain, is not combined with sensitivity disorders. Cervicalgia can be dull, aching. Sharp sharp "lumbago" pain is called cervicago. There is a spasm and muscle pain, soreness of the paravertebral points. Signs of cervical osteochondrosis intensify in an uncomfortable position, with head tilts, coughing, physical exertion. Signs of epicondylosis, humeroscapular periarthrosis and shoulder-hand syndrome appear due to nerve impulses from the annulus fibrosus of the affected segment, which causes compensatory muscle spasm.
Radicular syndromes are accompanied by impaired motor activity and sensitivity. At the same time, nerves, blood vessels are impaired, venous and lymphatic outflow in the pathological focus is disturbed as a result of a decrease in the intervertebral canal. Pain in radicular syndrome is acute, intense. A common cause of spinal nerve entrapment is hernia formation. In the area of the pathological focus, muscle tone decreases. With radiculoischemia, in addition to the nerves, the vessels are compressed.
If the phrenic nerve is involved in the pathological process, cardiac syndrome occurs. It manifests itself as a burning, acute pain in the left half of the chest with irradiation to the arm, the interduloid region. The name of the syndrome is due to the fact that the nature of the pain is similar to an attack of angina pectoris. The main difference between pain in angina pectoris is that it is relieved after taking nitroglycerin, it can occur at rest and is combined with interruptions in the heart rhythm (tachycardia, arrhythmia).
Signs of cervical osteochondrosis depend on the localization of the pathological process. With damage to the upper cervical vertebrae, the blood supply to the brain is disrupted due to compression of the cerebral arteries. This leads to headaches (especially in the occipital region), dizziness, fainting, high blood pressure. Dizziness with cervical osteochondrosis is caused by a decrease in blood flow to the inner ear. Patients are also worried about nausea, vestibular and ocular symptoms occur.
With a combined lesion of the vertebrae, they speak of cervicothoracic osteochondrosis. The disease is manifested by the following symptoms:
- Dizziness;
- Pain in the neck and arm;
- Tingling, creeping sensation on the upper limb;
- Intercostal neuralgia.
Diagnostics
Cervical osteochondrosis is a chronic disease that can lead to hernias and compression of the spinal cord. Therefore, it is important to establish an accurate diagnosis in a timely manner and begin therapy. To identify cervical osteochondrosis, the following types of instrumental diagnostics are used:
- Spondylography or X-ray of the spine. This research method is painless, highly informative and does not require special training. An X-ray of the spine makes it possible to assess its anatomical and functional features. In the picture, attention is paid to the structure of the vertebrae, their relation to each other, the distance between them, the lumen of the spinal canal;
- Computed tomography - provides information mainly about the state of bone tissue, allows you to identify a narrowing of the spinal canal and a herniated disc;
- Magnetic resonance imaging - allows you to determine the changes in soft tissues. The MRI image clearly shows changes in the intervertebral discs and spinal cord.
Drug treatment
Treatment of osteochondrosis of the cervical spine consists of drug and non-drug therapy. Even after a complete cure, neurologists carry out preventive measures to exclude relapses of the disease. In the acute period, for the treatment of osteochondrosis of the cervical spine, doctors prescribe to patients drugs of the following pharmacological groups:
- Non-narcotic analgesics. They are taken orally or injected intramuscularly to quickly achieve the effect;
- Non-steroidal anti-inflammatory drugs;
- B vitamins in large doses.
Diuretics are used to reduce fluid retention in the spinal root and surrounding tissues. Antihistamines potentiate the action of analgesics. Muscle spasms are eliminated by muscle relaxants. With prolonged severe pain syndrome, neurologists perform a nerve blockade.
To improve metabolic processes in the intervertebral disc, chondroprotectors are used. These drugs increase the content of glycosaminoglycans, increase the firmness, elasticity and shock absorption of the intervertebral discs.
Dizziness pills
Patients often experience dizziness with cervical osteochondrosis. To reduce them, doctors prescribe non-steroidal anti-inflammatory drugs. NSAIDs belonging to different groups differ in the mechanism of action and effect, therefore, only a qualified specialist can determine the appropriate drug.
It is important to remember that medications for osteochondrosis of the cervical spine cannot be taken without the appointment of a doctor. Non-steroidal anti-inflammatory drugs have side effects, therefore, before prescribing them, the neurologist determines the presence of contraindications in the patient and the required dosage. Drugs for dizziness with cervical osteochondrosis can improve the patient's quality of life.
Injections for osteochondrosis
Injections for osteochondrosis of the cervical spine help relieve pain during an exacerbation. With this method of drug administration, the effect occurs quickly. Neurologists use a variety of injections.
Nurses inject drug solutions subcutaneously, intramuscularly, or intravenously. During an exacerbation of the disease, drugs that are administered by injection, with cervical osteochondrosis, have an exclusively symptomatic effect.
Headache treatment
Headache is a symptom that occurs with various disorders. However, cervical osteochondrosis is characterized by bouts of intense headache. Head movements increase the symptoms, therefore, to eliminate it, doctors prescribe analgesic tablets and non-steroidal anti-inflammatory drugs.
Non-drug therapy methods
Complex non-drug therapy of cervical osteochondrosis of the spine includes:
- Protective mode - when the roots are pinched, patients lie on a hard surface,
- Massage;
- Physiotherapy exercises;
- Spinal traction;
- Physiotherapy procedures.
Massage for cervical osteochondrosis is used to reduce pain and edema, improve peripheral blood supply, and eliminate muscle spasm. A contraindication to performing this procedure is the presence of acute pain. Massage the neck and back in the direction of the outflow of lymph. Particular attention is paid to the interscapular and paravertebral zones.
Therapeutic gymnastics for osteochondrosis of the cervical spine is aimed at eliminating muscle spasm and strengthening the muscle frame. Since instability of the vertebrae often occurs in the cervical spine, the exercise therapy instructor conducts individual lessons, during which he teaches the patient to safely perform the exercises. Some authors recommend conducting physical therapy classes in the Shants collar.
To improve the mobility of the cervical vertebrae, rehabilitation therapists recommend performing the following exercises:
- Flexion and extension of the neck. Tilt your head forward towards your sternum, without pulling your shoulders forward, then back. Hold the incline for 3 seconds, repeat each exercise 8-10 times;
- Turns of the neck. Turn your neck first to the left until it stops, then to the right, without changing the position of the shoulders and the level of the chin;
- Lower your head down until it stops. Then tilt your head back without changing the level of your shoulders. Hold the position for 5 seconds.
The following exercises have been developed to strengthen the muscles of the neck:
- Place your hand on the back of your head. Tilt your head back, resting on your hand;
- Place your hand in the temporal region. While tilting your head, resist with your hand;
- Put your hand on your forehead, resisting it, tilt your head forward;
- Tilt your head to the side with your right hand, with your left hand behind your back. Repeat the exercise on the other hand.
Autogravity therapy is the exact name of the spine traction procedure. It is carried out using special devices. The goal of therapy is to reduce muscle spasm and restore the correct position of the vertebrae. In order to avoid complications, the spinal traction is carried out by a doctor.
To improve blood supply in the pathological focus, relieve puffiness and eliminate pain, the following physiotherapeutic procedures are used:
- Diadynamic currents. During this procedure, using a special apparatus, low-frequency currents are supplied, which stimulate muscles, relieve spasms and pain. Have a positive effect, improving tissue trophism;
- Ultraviolet irradiation. Under the influence of UV radiation, the metabolism of vitamin D improves, the calcium content increases, the bone tissue becomes stronger;
- Exposure to ultrasound - used to accelerate blood flow, antispasmodic and reparative action. Ultrasound is able to penetrate deep into tissues, sometimes it is used for better absorption of medicinal substances;
- Amplipulse therapy - allows you to relieve pain by blocking nerve impulses from the painful focus.
In the acute period of the disease, which lasts 4-7 days, pain relievers, antispasmodics, irritants are used to reduce pain. The patient is provided with peace. Immobilization of the cervical spine is carried out using the Shants collar. Exercise therapy and massage are contraindicated. Apply ultraviolet radiation.
The duration of the subacute period is 29 days. After complete recovery, the patient must take rest for several days. Then you can start a course of rehabilitation therapy. In the chronic course of the disease, the patient is prescribed muscle relaxants, chondroprotectors, B vitamins, for pain - analgesics, NSAIDs. Physiotherapy exercises, massage are carried out. The patient is released physiotherapeutic procedures (amplipulse, exposure to alternating current), spinal traction is done.
Food
Proper nutrition for osteochondrosis is an important condition for achieving remission. The progression of cervicothoracic osteochondrosis stops with diet and treatment. Neurologists know how to treat osteochondrosis of the cervical spine, therefore, they make up a complex of therapeutic measures, including procedures, exercise therapy, proper nutrition and lifestyle changes.
Many patients turn to neurologists with the question of how to treat osteochondrosis of the cervical spine and whether there are any dietary restrictions. Specialists create individual nutrition programs that take into account the patient's preferences. The diet for osteochondrosis is based on balanced, low-fat food that is rich in nutrients. The patient's daily diet includes foods high in calcium.
How to sleep with cervical osteochondrosis
For patients with diseases of the musculoskeletal system, the question of how to sleep properly with cervical osteochondrosis is relevant. Sleeping on your stomach provokes further development of the disease, so it is better to avoid sleeping in this position. The most optimal positions are on the back and side.
Cervical osteochondrosis progresses while resting on a bed with a soft mattress. Therefore, experts recommend giving preference to elastic mattresses, as well as moderately soft pillows. If a patient is diagnosed with cervicothoracic osteochondrosis, experienced specialists will tell you which bedding is safe for sleeping.
Prophylaxis
To prevent the onset or progression of cervical osteochondrosis, doctors recommend:
- Maintain correct posture;
- Lead an active lifestyle, take breaks at work;
- Do physiotherapy exercises regularly;
- Sleep on a firm and level surface, orthopedic mattress and pillow;
- Get rid of bad habits, especially smoking;
- Choose shoes taking into account the physiological structure of the foot;
- Do not carry bags on one hand, this leads to a bending of the spine;
- Lead a healthy lifestyle, eat right, eat lots of fruits and vegetables;
- Does not sit for a long time with the head tilted;
- Go swimming.
In order to improve blood circulation, massage therapy should be carried out regularly.